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HomeMy WebLinkAbout026-1064-70-000 t ST. CROIX COUNTY ZONING DEPART IV-L-11 AS BUILT SANITARY REPORT ! -' 'R v, , Owner /Zi�STFee Cf LFi � l L Property Address y s' y C I't City /State 101 /PzC# 2Lo -,yb wt S V m 17 CR �rX r .: NG Q FCE Legal Description: Lot -- Block Subdivision/CSM # S� t /4 IVAff t /4, Sec. �/ , TAN -R // W, Town of l�- �g,�,�r�+g& PIN # �oGy 70 SEPTIC TANK — DOSE CHAMBER — HOLDING TANK INFORMATION Tank manufacturer Size ST/PCI /) Setback from: House 7 -' Well a' P/L Pump manufacturer G OGlGD Model q Alarm location (HOLDING TANKS ONLY) Setbacks: Service road Vent fresh air intake Water Line Meter location Alarm location SOIL ABSORPTION SYSTEM Type of system: Width / 2 Length 7 2 Number of Txenehes Setback from: House > /Sb' Well >!So' P/L - ?/v' Vent to fresh air intake 3s'� ELEVATIONS Description of benchmark L:2 A Pewvf. of- W zwz 4,#A41 Elevation 1,no. e Description of alternate benchmark w--zz Elevation o rc s- 7. Cho 711 N�' -i guikfiag Sewer yo ST/f19F-Inlet 9 5.,? ST Outlet ^' PC Inlet PC Bottom ", 54 Header/Manifold 9 7, ©d' Top of ST/K— Manhole (over 9G • 5 6 Distribution Lines ( Bottom of System ap Final Grade Date of installation, l,V Permit num er 97S/ State plan number Plumber's signature / �- = License number 2 /�dl/ Date /1 /3a l Inspector Complete plot plan e- NOTICE Please provide the following: • A plan view sketch showing everything within 100 feet "I's systom • Two horizontal reference points to center of septic tank n Lanhole cover. • Show alternate benchmark, if applicable. ?pLF PLAN VIEW A R r # / 7.2 w r x � X i L1_ -d 7 i 25 �' �SEro w =G� ro D ,sr INDICATE NORTH ARROW - Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Buildings Division Count,, . INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Sanitarft"lo.: Personal information you provice may be used for secondary purposes [Privacy L , s.15.04 (1)(m)]. TECHT RUSSELL i, f d e Town of: State Plan ID No.: CST BM Elev.: Insp. BM Elev.: BM Description: Parcel�Q #_ TANK INFORMATION ELEVATION DATA Aga(Q611� I - s TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. eptic �/ ". ? /- �y / / 2- c� Benchmark �6' �� 6 6." Dosing Aeratio Bldg. Sewer Holding St /Ht Inlet 5's TANK SETB CK INFORMATION St/ Ht Outlet 3r Z3 TANKTO P/L WELL BLDG. ventto Air lntake ROAD Dt Inlet Septic v �� ( � �g�. NA Dt Bottom SS= Y -1 2 Dosing NA Headert1%A. Y/r Aeration NA Dist. Pipe 2"p �, 6y' Holding Bot. System PUMP/ SCI INFORMATION Final Grade Manufacturer `Y' CJ Demand In At Cs 4 - e4 Model Number GPM TDH Lift g d' Lriction / System 1� TDH Ft H ead Forcemain Length ; �2 Dia. Dist. To Well SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIMENSIONS Z- DIM SYSTEM TO P/ L BLDG WELL LAKE/STREAM LEA Manu rer: SETBACK INFORMATION Type Of life -' CHAMBER OR UNIT Moe u e,: System: C.�++ / &d DISTRIBUTION SYSTEM Header / Distribution Pipe(s) r x Hole Size x Hole Spacing Vent To Air Intake i Length (b ° Dia. Length Dia. $Z/ Spacing _ SOIL COVER x Pressure Systems Only xx Mound Or At - Grad stenirGnly Depth Over Depth Over xx Depth Of xx Seeded/ Sodded xx Mulched Bed/ Trench Center Bed /Trench Edges Topsoil ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS (Include code discrepancies, persons present, etc.) LOCATION: RICHMOND 21.30.18.324A,SE,NE 14 Cot&TY VAD S ,7 Plan revision required? [ U v Use other side for additional information. �--� SBD -6710 (R.3/97) Date Inspector's Signattre Cert. No. N A SANITARY PERMIT APPLICATION ` 201 E.W Avivision b cons i n A m P.O. Box 7969 Ave. Department of Commerce In accord with ILHR 83. 05, WIS. d Code Madison, WI 53707 -7969 • Attach complete plans (to the county copy only) for the system, on paper not less County than 81/2 x 11 inches in size. • See reverse side for instructions for completing this application State Sanitary Per It Nummb The information you provide may be used by other government agency programs E] Check if revision to previous Application [Privacy Law, s. 15.04 (1) (m)]. -94 3o. / ?. L !7st�� State Plan I.D. Number I. APPLICATION INFORMATION -PLEASE a7 PRINT ALL INF RMATION Property Owner Name cation 1/a 1/4, S T , N, R E (or� Property Owner + ,, ' ' ,ss Mailing Address Lot Number Block Number L) 49 /Y.S �' -- City, St e Zip Code Phone Number Subdivision Name or CSIVI Number XJA - c ,- 7 ( .7 O I. TYPE OF BUILDING: (check one) ❑ State Owned ❑ O Nearest Road ❑ Village Public 0 1 or 2 Family Dwelling - No. of bedrooms Town OF III. BUILDIN USE: (If building type is public, check all that apply) arcel Tax Number(s) C 1 E] Apart ment / Condo N 5 q 120 4am. st. N A 24 - to IN— 7,0 2 ❑ Assembly Hall 6 ❑ Medical Facility/ Nursing Home 10 ❑ Outdoor Recreational Facility 3 E] Campground 7 ❑ Merchandise: Sales/ Repairs 11 ❑ Restaurant/ Bar/ Dining 4 ❑ Church/ School 8 ❑ Mobile Home Park 12 ❑ Service Station/ Car Wash 5 ❑ Hotel/ Motel 9 ❑ Office/Factory 13 ❑ Other: specify IV. TYPE OF PERMIT (Check only one box on line A. Check box on line B, if applicable) A) 1. ❑ New 2. Replacement 3, ❑ Replacement of 4. ❑ Reconnection of 5_ ❑ Repair of an System ----- - System _______ ______ Tank i _Ony Eii S Existing ______________ xstng System _ ^__ System ----- - - - --g st Sy- m B) ❑ A Sanitary Permit was previously issued. Permit Number Date Issued V. TYPE OF SYSTEM: (Check only one) Non - Pressurized Distribution Pressurized Distribution Experimental Other 11 Seepage Bed 21 ❑ Mound 30 ❑ Specify Type 41 ❑ Holding Tank 12 ❑ Seepage Trench 22 ❑ In- Ground Pressure 42 ❑ Pit Privy 13 ❑ Seepage Pit /l X 7 43 ❑ Vault Privy 14 ❑ System -In -Fill Age VI. ABSORPTION SYSTEM INFORMATION: 1. Gallons Per Day 2. Absorp. Area 3. Absorp. Area 4. Loading Rate 5. Perc. Rate 6. System Elev. 7. Final Grade Required (sq. ft.) Proposed (sq. ft.) (Gals/day /sq. ft.) (Min. /inch) Elevation 440 1 FrI , Q Feet aP,0 Feet Ca "I VII. TANK in g al lons Total # Of Prefab. Site Fiber- Exper. INFORMATION New Existin Gallons Tanks Manufacturers Name Concrete st on- Steel glass Plastic App Tanks Tanks Septic Tank or Idirig -look ❑ ❑ ❑ ❑ 1 ❑ Lift Pump Tank /Siphvrrr hamber I ❑ I ❑ ❑ Eli ❑ ❑ VIII. RESPONSIBILITY STATEMENT c t_,+t���� I, the undersigned, assume responsibility foT the on site sewage system shown on the attached plans. Plumber's Name: (Print) Plumber's Signature: o tamps) PRSW No.: Business Phone Number: Aeorl) F, « a u r s Address (Street, City, State, Z' ode): d � IX. O NTY D PARTME USE ONLY ❑ Disapproved Sanitary Permit Fee (Includes Gro ate Issued ssuin ent Signature (No Stamps) jJ Approved []Owner Given Initial j (� Surcharge Fee Adverse Determination ( - �v 1 Cc X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: SBD -6398 (R.11/96) DISTRIBUTION: Original to County. One copy To: Safety & Buildings Division, Owner, Plumber I � ' ~� U `^ 0 K � i Purf,P CHAMBER CROSS SEC IOrI AtvG SPECIFICA*rims VEAJT CAP 'i"C.I. VElQT PIPE WEATHERPROOF APFROVED LOCKIAIG 25' F RO,^1 DOOR, JUAJCTIOAJ BOX MAIJHOLE COVER S WIMDOW OR FRESH 12 "MIU. AIR INTAKE I GRADE ( Y MIIJ. — _ COWDUIT 18" Pq u. 18 "MIAI. ---- -- -- -- � 11� IM LE T PROVIDE AIRTIGHT SEAL � I I I I I ALARM 6 I I) I c *APPROVED i ou JOINTS WITH I ELEV FT. APPROVED PIPE - -� 3' ONTO PUMPS OFF D SOLID SOIL COUCRETE BLOCK RISER E XIT PERMITTED OIJLy IF TAWK MAUUFACTURCR HAS SUCH APPROVAL SEPTIC E SPECIFI CAT IOk]S , 4 DOSE TANKS MALI UFACTURCR: (DUMBER OF DOSES: PER DAy TAWK SIZE: GALLOUS DOSE VOLUME 7 ALARM MANUFACTURER: IMCLUDING BACKFLOW: - GALLONS MODEL ►DUMBER: � f, "iCGJ TfiZN/f CAPACITIES: A= :U WCNES OR Jf Z S� GALLOWS SWITCH TYPE: itM= �,; fZ /1? 5= 6� INCHES OR —3 GALLOW5 PUMP MAIJUFACTURFR: L' i o'.L1.> C IUCHES OR -Z GALLOLIS MODEL AIUMDER: D = IMCHES OR — 6-1 GALLONS SWITCH TYPE: DOTE: PUMP AND ALARM ARE TO BE MIWIMUM DISCHARGE RATE — GPM INSTALLED OU SEPARATE CIRCUITS VERTICAL DIFFEKEMCE BETWFLCU PUMP OFF AAJD DISTRIBUTION PIPE,. - /� FEET + eM�lkJJIIMUM METWORK SUPPLY PRESSURE . . �Y`-� FEET FEET OF FORCE MAIN X F / .x FEET 100fxFRiCTION FACTOR.. TO AL D 3MAMIC. HEAD FEET IMTERKJAL DIMEIJSIOIJG OF TA►JK: LEAI&TH 4Z - ,WIDTH k � ;LIQUID DEPTH S2 51GNED: LICENSE I�JUMBER: - j�i� 9 i DATE - -— -- — MODEL i • • PO4 • 0 Su bmersible Effluent Pump �h5 n, METERS FEET n { 70 MODEL: 3871 r J41 �a dlli g 30 olids e Motor , , 25 Y 7 Single phase:I15V� 5 zo Materials of Construction _ Brass/thermoplastic e 5 15 EP05 Features and Benefits o *Top suction eliminates e 3 ,o impeller clogging. 2 EPOa 5 • Corrosion resistant construction. ° ° 10 20 30 +0 50 uscrM •Float actuated switch. 0 2 4 6 8 10 12 Baer CAPACITY METERS FEET MODEL DvPO3 Pump Specifications Features and Benefits 0 520 O ho and ' /Z HP • EPO4 impeller- semi -open design = 5 Up to 60 GPM with pump out vanes to protect 15 Maximum head to 32' mechanical seal. 4 Discharge size 1 NPT • EP05 impeller - enclosed design 3 10 Solids: 3 / +" maximum for improved performance. 2 5 Motor • Rugged glass - filled thermoplastic 1 All motors feature ball casing and base design provides ° 0 bearing construction. superior strength and corrosion 0 5 10 15 20 25 30 35 a0 U.S.OPM resistance. Single phase: 115V 0 2 caPaciTY 6 e 10 rob Materials of Construction • Cast iron motor housing for Cast iron efficient heat transfer, strength, Thermoplastic and durability. Stainless steel • Corrosion resistant threaded stainless steel shaft. • Available for automatic and manual operation. • CSA listed models available. All Models are designed for continuous operation and feature stainless steel hardware. ST. CROIX COUNTY ZONING OFFICE CERTIFICATION STATEMENT FOR UTILIZATION OF AN EXISTING SEPTIC TANK This is to certify that -I have_ inspected_ the septic tank presently serving the � T- z4viff(f 14 residence located at: T— s 5: Section a4 , T R /Z W, Town of _/zz j*0� 2 . Upon inspection, I certify that I have found the tank and baffles to be in good condition, and it appears to be functioning properly. Last time serviced: ,� / j V Did flow back occur from absorption system? Yes X, No (If no, skip next line) Approximate volume or length of time: gallons minutes Capacity: ) X Construction: Prefab Concret Steel Other Manufacturer: (If known): Age of Tank (If known): ai l" ; A-7-7— r (Signature) (Name) Please print / q (Title) (License Number) Date Form to be completed by licensed plumber (s.145.06, Wisconsin Statutes) or Licensed Disposer (NR 113 Wisconsin Administrative Code) - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Plumber (applying for sanitary permit) Certification: In accepting the above statement regarding existing septic tank condition, I certify that the tank to the best of my knowledge will conform to the requireme is of ILHR 83, Wis. Adm. Code (except for inspect' n opening ova outlet baffle). i Name � /; Signature MP- /MPRS a, [0 F It Wisconsin Department of Commerce SOIL AND SITE EVALUATION _ Z Division of Safety and Buildings Page of _ Bu,reau of lhitegrated Services in rt;g'�Ivith s. ILHR 83.09, Wis. Adm. Code r° Attach complete site plan on paper not less tha �'142`x inct in size'<Pkan�hnust County include, but not limited to: vertical and horizo at re,Yerenc ft directipo-`e�d percent slope, scale or dimensions, north arrgW avid locati i ce to nearest road. Parcel I.D. # :,( r APPLICANT INFORMATION - Pleai�e rint al /t�it '' Reviewed by Date Personal information you provide may be used for se ortdary purpose Law, s. 1 spd C4 (m)). Property Owner P.tbperty Location Govt. Lot fC 1/4 NE 1 /4,S / T �a ,N ,R E (ore Property Owner's Mailing Address Lot # Block# Subd. Name or CSM# City State Zip Code Phone Number ❑ City [:1 village [X Town Nearest Road ❑ New Construction Use: Residential / Number of bedrooms Addition to existing building Replacement ❑ Public or commercial - Describe: Code derived daily flow '''*o gpd Recommended design loading rate bed, gpd/fi trench, gpd /ft Absorption area required f��� bed, ft 7.50 trench, ft Maximum design loading rate bed, gpd /fie trench, gpd /ft Recommended infiltration surface elevation(s) f r ft (as referred to site plan benchmark) Additional design /site considerations . A1, s9 /Vgnc7 FAz( - 1 rCj1_. YX . Parent material Flood plain elevation, if applicable ft S = Suitable for system Conventional Mound In- Ground Pressure AT -Grade System in Fill Holding Tank U = Unsuitable for system EIS U 4 S El E] S U El U ❑ S U ❑ S ZI U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench .2 tk /Lt ez 4. Ground _ S 1 E M L 8 elev. fS'�ft• 7 � - � -- S '_ Depth to 7' E limiting factor FL" in. Remarks: &Z Boring # Z2 Ground elev. ft. Depth to limiting factor in. Remarks: CST Name (Please Print) Signature Telephone No. Address Date CST Number AA& 2 / �a SOIL DESCRIPTION REPORT PROPERTY OWNER Page of PARCEL I.D.# Boren # Horizon Depth Dominant Color Mottles Structure 2 Boring Texture Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench , , Ground elev. ft. Depth to limiting factor in. Remarks: Boring # Ground elev. ft. Depth to limiting factor in. Remarks: Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench Boring # ........................... I Ground elev. ft. I Depth to limiting factor ' Remarks: Boring # Ground elev. ft. Depth to limiting factor in. Remarks: SBD -8330 (R. 07/96) � o S ~ N t /. .> , y Z 1 O Q N ti IM it C n ►+ � �i o �► �' psi n � 04 y � c o ( M O n° 0 Z 1 Wisconsin Department of Commerce SOIL AND SITE EVALUATION Division of Safety and Buildings Page __L of - Bureau of Integrated Services in accordance with s. ILHR 83.09, Wis. Adm. Code Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must County include, but not limited to: vertical and horizontal reference point (BM), direction and _ CR percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. # 2ti-0t -'� O.z - /� �� - 7a APPLICANT INFORMATION - Please print all information. I� RZ 'ewe by ate Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner Property Location 4f LL Q7- , E e_HT Govt. Lot 1/4 1 /4,S T� ,N,R E (0 Property Owner's Mailing Address Lot # Block# Sub . Name or CS M# Z j q �— city State Zip Code Phone Number ❑ City g ❑ Village / Z Town Nearest Road r3 7 1 ( ? D o t w Construction Use: Residential / Number of bedrooms _ Addition to existing building FF eplacement ❑ Public or commercial - Describe: Code derived daily flow 90 gpd Recommended design loading rate _ bed, gpd /fi k trench, gpd /ft Absorption area required bed, ft 750 trench, ft Maximum design loading rate 7 _ bed, gpd /ft • J' trench, gpd /ft i Recommended infiltration surface elevation(s) ;P * ft (as referred to site plan benchmark) Additional design /site considerations VIC .rA//-CT VV Parent material Flood plain elevation, if applicable ft S = Suitable for system Conventional Mound In- Ground Pressure AT -Grade System in Fill Holding Tank U = Unsuitable for system S❑ U S❑ U [7 S❑ U � S El ❑ S j U E] S 0 U SOIL DESCRIPTION REPORT w .r,CGD Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench lex-7 ,*-.2J- — 5 &k 4 15C 5 -- Ground J el le e � v j =e r ft 7 jr Depth to limiting .r factor yin. 4 vu Remarks: Boring # 2 Aj I F S 2 z — L F �- G. z 3 4 z. S a 7 , Ground 7� ^S �ellevv.. n r P f %I 3 Depth to limiting factor >in. Remarks: CST Name (Please Print) Signature Telephone No —' r < ow Address Date CST Number A fs 2 // �d SOIL DESCRIPTION REPORT PROPERTY OWNER C�T�C4T Page Z of: 3 PARCEL I.D.# Boring Horizon Depth Dominant Color Mottles Structure 2 g in. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Boundary Roots Bed Trench 3 - o — S a' .3 .� N o Ground 3 d— _� elev. y _4/ fi. 1 depth td limiting factor Remarks: ��e�•r Boring # ir ........................... .......................... .......................... .......................... ........................... .......................... Ground elev. ft. Depth to limiting factor in. Remarks: Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench Boring # Ground elev. ft. Depth to limiting factor in. Remarks: Boring # .......................... Ground elev. ft. Depth to limiting factor in. Remarks: SBD -8330 (R. 07/96) s s� N ik o ^ a wzw o 0+ i it it l + W r % N h �. 'i nr P t n A e �►f n Q n � n c C y 6 - ST CROIX COUNTY l SEPTIC TANK MAINTENANCE AGREEMENT OWNERSHIP CERTIFICATION FORM Owner/Buyer Ai_651 O rf'c d� % Mailing Address CTti G __ Property Address z (Verification required from Planning Department for new construction) City /State Parcel Identification Number 1evikZ-- 20 _ LEGAL DESCRIPTION Property Location /� '/ <, Z 1 49 '/4, Sec. T_ N -R X W, Town of Subdivision , Lot # Certified Survey Map # . Volume , Page # Warranty Deed # S"/ / 91 . Volume An 7 3 . Page # 7 Spec house ❑ yes fig- Lot lines identifiable CYyes ❑ no SYSTEM MAINTENANCE f?�LL- ryST�� Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. I/we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 days of the three year expiration date. - — 42�� /,Z /L/i gg - - ' NATURE OF APPLICANT DATE OWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. C ATURE OF APPLI ANT DATE * * * * ** Any information that is mis- represented may result in the sanitary permit being revoked by the Zoning Department. * * * * ** O ** Include with this application: a stamped warranty deed from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty deed I . �. sisisi i+13'1U 1.74 Qurr CLAIM DIKED r ? � t...� ISTER'S OFFICE Ila" W. UJ@dK a ses>reI w, gait ebiess b Ito" U W. add e d Jame" h1.. L%cht, bobead ri wdlk as sesesrlW srsvii Wh1p ply, dw fAo.i� j S � re W d mhos in st Groat Gouty, Sob of WiscoNeW f _ APR 8 1994 1i:oo__ A. ,.: t RgOese�rei��� Raturn to i E�' r Tax Parcel No.: E th of NE K; E 3/4 of W 1 l4 of NE Si and NE 5i of SE Sf; all in Section 21, Township 30 North, Range 18 West, EXCEPT a parcel described as follows: Commencing at the NE comer of said Section 21; thence S alon the E line of said Section 21, 1995.30': thence W 33.0' to the pant of beginning, thence continuing West 209.00'; thence S 208.50'; thence E 209.00'; thence N 20630' to the point of beginning. Subject to easements, reservations and rights of ways including road easement. This is homestead papmey. l Daoed this S4k dry of : 1 , 1994. x (SEAT. W. UwAt AMIUMICATION ACKNOWLEDGMENT Sisoatw*s) STATE OF WISCONSIN ) m . ST. CROIX COUNTY ) authenticated this day of nn Petsoaafly came befofe me this `,! day of AeKIs.. , 19%, the above -named RumH W. Utwhi to me • ><emn to be the person who executed the fbngoia= instrue mt rm.a: hiowsm were LAR of wncoxM ae d acbwwladp af oot. by 1706.06, VPu. sho-) TIM DGMUMEff WAS DRAMM BY = QA� L pA , %k ' 56 Matt W. Swamn, Attorney Igotmy Public, St Croix Cam W . Ens Claire, Wisconsin MY com"inian mpir m i b t 3 rl Co �pA ,&Watts in